| NPI | 1285631499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: OH 35133774) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD60580578) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: WA MD60580578) | |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2018-05-07 |